Rainbow StethoscopesThank you for sharing your health provider recommendations with us! The information you provide below will allow us to contact LGBTQ-affirming health care providers located the Hudson Valley and invite them to be included in our Directory of LGBTQ Affirming Health Care Providers.

At the bottom of this form, we ask you to provide some optional information about yourself. This is so that we have some general, demographic information about the person who refers each health provider in our directory. We will not associate your name or other personally identifiable information with the data we receive. In fact, you do not need to provide your name to make a recommendation. We ask for your email address only so that we can contact you if we have questions about the referral you submit.

Health Directory Recommendation Form

Please submit this form once for each provider you would like to recommend.
  • About the Provider

  • Examples: General Practioner, Endocrinologist, Mental Health Professional, etc.
  • About You

  • Please provide your email address so that can contact you if we have questions.

Thank you for your valuable input! We’ll reach out to the provider you recommended.